- Email: [email protected]
Drugs Affecting Lipid Metabolism
International Journal of Cardiology 45 (1994) 153-l 56
Book reviews Advances in Echo Imaging Using Contrast Enhancement N.C. Nanda, R. Schlief Kluwer Academic Publishers, Boston, 1993; 405 . stgf79.50, US$122.00, Dfl 200; ISBN :%23-2137-5 Echocardiography, as an investigational modality, is well established and widely available. In addition, continued advances in both hardware and software are likely to keep echocardiography at the forefront of clinical cardiology. Contrast echocardiography is one such aspect allowing improved imaging and assessment of cardiovascular structure and function. This field has recently been reviewed by Nanda and Schlief. In their book, Nanda and Schlief have brought together a number of experienced clinicians and scientists and constructed a balanced, well-written and detailed account of the current state of contrast echocardiography, its present limitations and future potential. Divided into three parts, the book begins with a historical perspective, basic principles and the currently available contrast agents, as an introduction to those with little prior experience in this field. These introductory chapters are, however, complex containing detailed mathematical principles and formulae regarding the physics of ‘microbubbles’, the essential cornerstone of contrast echocardiography. The second part of the book concentrates on the current clinical applications and advantages of contrast echocardiography. This ranges from its most simple form, the detection of spontaneous contrast in low flow states, to the intravenous and intracardiac injection of artificial contrast material. Examples of contrast echocardiography with its potential to aid the visualisation of cardiac structure, the detection of intracardiac shunts, the enhancement and clarification of Doppler and colour flow Doppler investigations are both well described and illustrated. The future direction of contrast echocardiography, in the analysis of coro-
nary blood flow and myocardial tissue characterisation, is outlined in detail in the final section. Both these areas have considerable clinical potential. The major limitation of contrast echocardiography, however, currently remains the absence of an agent which, in addition to not altering cardiovascular function, is able to cross the pulmonary circulation. This would allow accurate visualisation of left sided cardiac structure and, most importantly, detailed analysis of left ventricular function and myocardial perfusion following intravenous injection. This shortcoming and its potential solutions are well addressed in the book. Nanda and Schlief have edited and produced an authoritative and up-to-date reference book for both experienced and inexperienced echocardiologists. I strongly recommended this publication to those interested in this field. Cardiac Department
Dr S Fort
Western General Hospital Crewe Road Edinburgh, UK
SSDI
0167-5273(94)02020-j
Drugs Affecting Lipid Metabolism A.L. Catapano, A.M. Gotto, L.C. Smith, R. Paoletti (Editors) Kluwer Academic Publishers, Dordrecht, 1993; 521 pp.; st&107.00, US$159.00, Dfl 270.00; ISBN 0-7923-2232-O This book is based on the invited papers from the 11th International Symposium on Drugs Affecting Lipid Metabolism held in 1992 in Florence. The contributions are in the form of the typescript provided by the authors, giving the usual uneven and often uninviting presentation which characterises such books. That said, how-
Book reviews/h.
154
ever, there is nothing uninviting about many of the contributions themselves. Many of these contain ideas crystallised in the small space that each of the 60 presenters has been allowed which make the book wellworth browsing through and many contributions are well referenced. Purchasers should not be misled by the title: the book contains very little about drugs for the treatment of hyperlipidaemia. It contains contributions ranging from clinical epidemiology to the cell biology, biochemistry and genetics of atheroma. It is a book for those active in research into atherogenesis. A potential criticism is, of course, that despite its presentation as an express publication the book has taken well over a year to be published. Indeed the 1993 meeting has taken place whilst this book was in preparation. The problems of whether to go to press omitting tardy authors, whose contributions may be the most illustrious and interesting, is, however, a perennial one and the achievement of the editors should not be underestimated: they are to be congratulated. Department of Medicine Manchester Royal Infirmary Oxford Road Manchester Ml3 9WL. UK SSDI
Dr P. Durrington
0167-5273(94)02023-C
Ehocardiography (5th Edition) Harvey Feigenbaum, M.D. Lea & Febiger, 1994 695 pp.; stgE70.00; ISBN O-8121-1692-5 It is one of the pleasures of book reviewing, to be asked to review what has become the ‘standard’ text in a particular subject. When I was a trainee in cardiology, and some unusual appearances were noted during echocardiography, the chorus went up: ‘Is it in Feigenbaum?’ and it always was. The new edition is still very much a single author effort, although the comprehensive 80-page chapter on congenital hearing disease is by Thomas Ryan who runs the adult congenital heart disease clinic at Indiana University Medical Centre. As with previous editions this book is copiously illustrated with excellent black-and-white and colour pictures. Whilst in some textbooks the images from twodimensional echocardiographic studies are difficult to understand, echocardiography after all being about moving structures, this book manages by combining two
J. Cardiol.
45 (1994)
153-156
or sometimes more images to give a sense of what one sees when imaging. This book includes all the newer techniques including transoesophageal echocardiography, intravascular ultrasound and stress echocardiography. There is also a welcome chapter on the derivation of haemodynamic information from echocardiography, an important antidote to those whose first impulse is to turn on the colour flow mapping, and thereby miss important diagnostic information. Feigenbaum is always quite frank about the limitations of echocardiography and doppler studies, particularly in the quantitation of valvular regurgitation, diastolic dysfunction and right ventricular function. There is a very useful and extensive appendix containing details of methods for echocardiographic measurements and the ranges of normal values. This edition will ensure that Feigenbaum’s Echocardiography remains the ‘standard’ text, and will continue to deserve its place in echocardiography laboratories throughout the world. Royal Hull Hospitals Trust Hull Royal Infirmary Anlaby Road
John L. Caplin Consultant Cardiologist
Hull HU3 232 SSDI
0167-5273(94)02036-l
Difficult Concepts in Cardiology G. Jackson Martin Dunitz, 1994 384 pp.; stgf49.95;
ISBN
l-85317-11 l-5
As a general rule, concepts are ‘difficult’ if they are illunderstood or poorly explained. Neither of these, and certainly not the second, could be applied to this collection of essays on cardiological topics edited by Graham Jackson, which is perhaps why I find the title rather irritating. Many of the chapters, in fact, address mainstream topics in cardiology ranging from drug therapy for patients with angina pectoris, through the role of angioplasty and surgery in acute myocardial infarction to the Wolff-Parkinson-White Syndrome, cardiac investigation of transient ischaemic attacks and stroke, primary pulmonary hypertension in pregnancy and endocarditis. The chapters are very readable, the approach is scientific but not impossibly erudite (and even, dare one whisper it, somewhat anecdotal) and the general level is that of good, crisply delivered postgraduate lectures. In the context either of continuing medical education or a
Book reviews Advances in Echo Imaging Using Contrast Enhancement N.C. Nanda, R. Schlief Kluwer Academic Publishers, Boston, 1993; 405 . stgf79.50, US$122.00, Dfl 200; ISBN :%23-2137-5 Echocardiography, as an investigational modality, is well established and widely available. In addition, continued advances in both hardware and software are likely to keep echocardiography at the forefront of clinical cardiology. Contrast echocardiography is one such aspect allowing improved imaging and assessment of cardiovascular structure and function. This field has recently been reviewed by Nanda and Schlief. In their book, Nanda and Schlief have brought together a number of experienced clinicians and scientists and constructed a balanced, well-written and detailed account of the current state of contrast echocardiography, its present limitations and future potential. Divided into three parts, the book begins with a historical perspective, basic principles and the currently available contrast agents, as an introduction to those with little prior experience in this field. These introductory chapters are, however, complex containing detailed mathematical principles and formulae regarding the physics of ‘microbubbles’, the essential cornerstone of contrast echocardiography. The second part of the book concentrates on the current clinical applications and advantages of contrast echocardiography. This ranges from its most simple form, the detection of spontaneous contrast in low flow states, to the intravenous and intracardiac injection of artificial contrast material. Examples of contrast echocardiography with its potential to aid the visualisation of cardiac structure, the detection of intracardiac shunts, the enhancement and clarification of Doppler and colour flow Doppler investigations are both well described and illustrated. The future direction of contrast echocardiography, in the analysis of coro-
nary blood flow and myocardial tissue characterisation, is outlined in detail in the final section. Both these areas have considerable clinical potential. The major limitation of contrast echocardiography, however, currently remains the absence of an agent which, in addition to not altering cardiovascular function, is able to cross the pulmonary circulation. This would allow accurate visualisation of left sided cardiac structure and, most importantly, detailed analysis of left ventricular function and myocardial perfusion following intravenous injection. This shortcoming and its potential solutions are well addressed in the book. Nanda and Schlief have edited and produced an authoritative and up-to-date reference book for both experienced and inexperienced echocardiologists. I strongly recommended this publication to those interested in this field. Cardiac Department
Dr S Fort
Western General Hospital Crewe Road Edinburgh, UK
SSDI
0167-5273(94)02020-j
Drugs Affecting Lipid Metabolism A.L. Catapano, A.M. Gotto, L.C. Smith, R. Paoletti (Editors) Kluwer Academic Publishers, Dordrecht, 1993; 521 pp.; st&107.00, US$159.00, Dfl 270.00; ISBN 0-7923-2232-O This book is based on the invited papers from the 11th International Symposium on Drugs Affecting Lipid Metabolism held in 1992 in Florence. The contributions are in the form of the typescript provided by the authors, giving the usual uneven and often uninviting presentation which characterises such books. That said, how-
Book reviews/h.
154
ever, there is nothing uninviting about many of the contributions themselves. Many of these contain ideas crystallised in the small space that each of the 60 presenters has been allowed which make the book wellworth browsing through and many contributions are well referenced. Purchasers should not be misled by the title: the book contains very little about drugs for the treatment of hyperlipidaemia. It contains contributions ranging from clinical epidemiology to the cell biology, biochemistry and genetics of atheroma. It is a book for those active in research into atherogenesis. A potential criticism is, of course, that despite its presentation as an express publication the book has taken well over a year to be published. Indeed the 1993 meeting has taken place whilst this book was in preparation. The problems of whether to go to press omitting tardy authors, whose contributions may be the most illustrious and interesting, is, however, a perennial one and the achievement of the editors should not be underestimated: they are to be congratulated. Department of Medicine Manchester Royal Infirmary Oxford Road Manchester Ml3 9WL. UK SSDI
Dr P. Durrington
0167-5273(94)02023-C
Ehocardiography (5th Edition) Harvey Feigenbaum, M.D. Lea & Febiger, 1994 695 pp.; stgE70.00; ISBN O-8121-1692-5 It is one of the pleasures of book reviewing, to be asked to review what has become the ‘standard’ text in a particular subject. When I was a trainee in cardiology, and some unusual appearances were noted during echocardiography, the chorus went up: ‘Is it in Feigenbaum?’ and it always was. The new edition is still very much a single author effort, although the comprehensive 80-page chapter on congenital hearing disease is by Thomas Ryan who runs the adult congenital heart disease clinic at Indiana University Medical Centre. As with previous editions this book is copiously illustrated with excellent black-and-white and colour pictures. Whilst in some textbooks the images from twodimensional echocardiographic studies are difficult to understand, echocardiography after all being about moving structures, this book manages by combining two
J. Cardiol.
45 (1994)
153-156
or sometimes more images to give a sense of what one sees when imaging. This book includes all the newer techniques including transoesophageal echocardiography, intravascular ultrasound and stress echocardiography. There is also a welcome chapter on the derivation of haemodynamic information from echocardiography, an important antidote to those whose first impulse is to turn on the colour flow mapping, and thereby miss important diagnostic information. Feigenbaum is always quite frank about the limitations of echocardiography and doppler studies, particularly in the quantitation of valvular regurgitation, diastolic dysfunction and right ventricular function. There is a very useful and extensive appendix containing details of methods for echocardiographic measurements and the ranges of normal values. This edition will ensure that Feigenbaum’s Echocardiography remains the ‘standard’ text, and will continue to deserve its place in echocardiography laboratories throughout the world. Royal Hull Hospitals Trust Hull Royal Infirmary Anlaby Road
John L. Caplin Consultant Cardiologist
Hull HU3 232 SSDI
0167-5273(94)02036-l
Difficult Concepts in Cardiology G. Jackson Martin Dunitz, 1994 384 pp.; stgf49.95;
ISBN
l-85317-11 l-5
As a general rule, concepts are ‘difficult’ if they are illunderstood or poorly explained. Neither of these, and certainly not the second, could be applied to this collection of essays on cardiological topics edited by Graham Jackson, which is perhaps why I find the title rather irritating. Many of the chapters, in fact, address mainstream topics in cardiology ranging from drug therapy for patients with angina pectoris, through the role of angioplasty and surgery in acute myocardial infarction to the Wolff-Parkinson-White Syndrome, cardiac investigation of transient ischaemic attacks and stroke, primary pulmonary hypertension in pregnancy and endocarditis. The chapters are very readable, the approach is scientific but not impossibly erudite (and even, dare one whisper it, somewhat anecdotal) and the general level is that of good, crisply delivered postgraduate lectures. In the context either of continuing medical education or a